Definition of Elder Abuse
The National Research Council defines elder mistreatment as "intentional actions that cause harm (whether or not harm was intended) or create a serious risk of harm to an older adult by a caregiver or other person who stands in a trust relationship to the elder, or failure by a caregiver to satisfy the elder's basic needs or to protect the elder from harm."
Effects of Abuse
Elders who are abused are more likely to have other health problems like depression, musculoskeletal complaints, chronic pain, high blood pressure and heart disease. They are also more likely to feel incapable of being independent. Worst of all, they have a 300% higher mortality rate than their peers.
Types of Abuse
- Physical Abuse – the intentional use of force to physically harm an elderly person.
- Psychological Abuse – belittling, putting down, humiliating, threatening,frightening, ignoring, verbally attacking, or rejecting, causing emotional upset to the elderly person – particularly if chronic.
- Sexual Abuse – In any way sexually engaging an elderly person without his or her consent
- Financial Exploitation – manipulation, fraud, tricks, etc. to essentially steal money or assets from an elderly person. Fraud from professionals who exploit seniors can also occur. This can be anything from overcharging for home repair services to getting unecessary medical procedures.
- Neglect – failure of a caregiver to meet emotional, physical, or safety needs of an elder
- Self Abuse and Neglect – Often due to an inability to cognitively understand, self-abuse and neglect occur when a person fails to take adequate care of self leading to harm or endangerment.
The Administration on Aging estimates that over 500,000 adults over the age of 60 in the USA are reported to have been abused or neglected yearly; however, because the reporting rates are thought to be very low, researchers believe that as many as 2 million are actually abused yearly in the United States. And in the case of abuse in the home, as few as 1 in 14 cases are thought to be reported. Almost half of all abuse cases are thought to be neglect.
Where Does Elder Abuse Take Place?
Elder abuse and neglect often takes place domestically - in the person’s home or the caregiver’s home by a family member or a trusted paid care provider. Institutional abuse is abuse that takes place in a nursing home, hospital, community program, or group home facility. Typically, institutional abuse occurs with a paid staff or volunteer in these professional settings.
Symptoms of Elder Abuse by Type
- Elder exhibits fear and anxiety and a desire to not be left alone with a particular person
- Burns, cuts, wounds, bruises, welts, puncture wounds – especially ones without plausible explanations or contradictory explanations
- Injuries that are left untreated or not treated by a doctor
- Injuries that are suspicious even if explained away – like a cigarette burn
- A noticeable awkwardness, fear, or anxiety when the elderly person is with the suspected abuser
- General fear, withdrawal or apathy
- Odd behavior such as sucking, rocking, or other new nervous motions
- Change in how often or the degree to which a person is upset
- Lack of a pleasant space to be in with personal items like photos, etc. – unclean or scary living conditions
- Isolated from others
- New oddly sexual behavior such as excessive flirting or coyness
- Soiled or bloody clothing
- Bruising, pain, itching, or other injuries near genitals
- Unexplained venereal disease
- Sudden or unexpected change of a person’s will, life insurance beneficiary, or other important estate matter
- Change in bank
- Sudden increase in credit card debt or lost credit cards
- Getting out large sums of cash from an account or having large sums of cash around
- Not paying bills on time
- The Senior is afraid to talk about money matters or offers implausible explanations for any of the above
Neglect and/or Self-Neglect
- Poor personal hygiene: hair, nails, teeth unkempt, may have an odor from not bathing.
- Isolated from others
- Wounds, bed sores, or injuries that are not being taken care of properly
- Not given appropriate clothing for the weather
- Unsafe, unsanitary conditions: untreated lice, bugs, lack of cleaning, fecal or urine not being removed from bedding or clothing, rotten food left behind,
- Loss of weight, malnourished, dehydration
- Lack of basic necessities like food, water, shelter, warmth, medical care
Unfortunately, abuse often comes from family or others close to the elder. It is a complicated issue and research into elder abuse is relatively new. What we do know is that there are many things that can contribute to abuse.
Financial Scams and Abuse
We know for example that caregiver stress is a risk factor. If the caregiver is depleted and overwhelmed, the person dependent on that caregiver is more at risk of becoming a victim of elder abuse or neglect. There are many caregivers, however, who are stressed and never harm anyone. So, stress alone is not the issue. Here are some characteristics of those who come to abuse a senior in their care:
- Previous history of criminality or violence
- Drug or alcohol abuse
- History of mental illness
- Depression and/or a lack of ability to handle stress
- Negativity about the person in his or her care
While in no way do the following risk factors imply that the elder is to blame for abuse, there are characteristics of the elderly person that can increase the likelihood of abuse as well.
An elder is more at risk if he or she:
- Has severe dementia and/or other condition that causes odd, aggressive, or difficult behaviors
- Is isolated and with just the caregiver most of the time
- Has a history of mental illness or previous family violence as either the perpetrator or victim
- Is verbally or physically aggressive
Impact of Elderly Abuse
Depending on the type of abuse, a person can become seriously ill or injured. Studies have shown that elders who are abused have decreased longevity. The effects on the family can also cause stress for everyone involved. The abuser also typically has a worsening of stress related problems, addiction, and/or physical health.
What to Do if You Suspect Abuse
It is never easy to report suspected abuse of any kind. Elder abuse can be difficult for a variety of personal reasons; however, if no one stands up for the elderly person, the abuse is likely to continue. If you have good reason to suspect abuse, there is a hotline for this in every state that is run through the Adult Protective Services system.
Elderly Protection Services
Once a report is made to APS, the APS worker will determine whether it is a crisis needing immediate intervention or if there is to be an investigation. The elderly person, if needed, will be offered services such as temporary shelter, healthcare services, etc. that are needed. The senior has a right to refuse any of these services.
Some of the best protection from abuse comes from ensuring that an elderly person is not isolated, has a variety of adults checking in routinely, and has some form of activity in life to keep the person from decline. From the caregiver perspective, the best help you can offer someone is respite. Ongoing nonstop care for a person can be enormously difficult and can result in a disintegration of a caregiver that could lead to abuse. Caregivers need help even when they claim they are “fine” without it. Offering to sit with someone so the caregiver can go out regularly can help.
The physical demands of caregiving often include long hours, no breaks, less attention on self-care, and lack of adequate sleep. Caregivers are twice as likely as non-caregivers to experience depression and anxiety.
In a nursing home situation, it is a well-known rumor that if a person does not have regularly visiting relatives or callers inquiring about someone, that elder may be last on the list of a busy day. Of course, not all facilities are like this – but it is important to check in regularly with the facility and your elderly loved one to ensure that good care is given and that there is nothing harmful going on. The more present you are, the less someone will think they can get away with harmful behavior toward an elderly person.
Financial abuse is often prevented with educating the elderly person about financial exploitation and some social skill training to ward off would-be manipulators. Often, just knowing that people are not to be trusted and that it is okay to be impolite to someone trying to scam money goes a long way toward preventing this type of abuse.
Elderly Financial Scams